Tuesday, January 28, 2014

Bicipital Tenosynovitis: Kenzo's Shoulder Injury

Kenzo's story is shared with us by my good friend @Kenzo_HW. Check out his blog, it's got awesome information on Hovawarts, tracking, nose work and lot's of other great stuff.

We are one month in on Kenzo's recovery from a shoulder injury. The progress is pain-stakingly slow, but there is progress, which is - and must be - the most important of all.

It started with a limp Kenzo developed last November. 

Actually, he also limped sporadically before that. But we could always manage with a couple of days of rest. When the days of rest got longer, and the interval between limps shorter, more thorough approach was needed..

It took a month of examinations, x-rays, wrong diagnoses, second opinions, more x-rays and examinations, and finally an arthroscopic exploration was done of both shoulders.

The tendon of his left shoulder was bad, very bad, and it had to be surgically transected.

Agility dogs frequently seem to have these types of injuries to the tendons in the shoulders due to repetitive strains. Although I never did agility with Kenzo, the scenario is recognizable, knowing how he behaves when we are out and about.

By the way. Why it was necessary to shave his whole front for such a tiny incision needed for an arthroscopic procedure remains a mystery.

Although the fur will grow back, the tendon unfortunately will not, but most dogs do recover just fine. According to the article Surgical Management of Bicipital Tenosynovitis via Arthroscopy:

Arthroscopic transection of the bicipital tendon, also referred to as tendon release, is the ideal surgical option. It consists of completely cutting the biceps tendon at the degenerative biceps groove. The tendon will adhere to the humerus over time, allowing future normal biceps muscle function.

Although vets don't seem to agree whether the biceps tendon will recover to a level that can support Kenzo's previous activity level, it should be possible to get very close, if we follow a rigid program of short leashed walks and physical therapy during the months to come.

Short Leashed Walks

I thought it wouldn't be possible. Kenzo on short leashed walks - a maximum of  four walks a day, 15 minutes each - sound like a contradiction in itself. But it is going good. Very good indeed. His "shave" from the operation keeps others at bay, and people are, surprisingly, really nice to ask before they approach with their dogs.

I soon learned that the "Halti" was necessary, as Kenzo tried to expend as much energy as possible in each short walk, and it became more like trying to keep my eyes on a bouncing ball, instead of walking a dog.

He is very aware of the "Halti", and it automatically seems to keep him calm during walks.

We find fun things to do, do a lot of sniffing, so we at least can stay out longer, and why not do a 45 minute drive to the beach, even if you can only walk for 15 minutes? Getting your paws wet and sandy, is always a feast.

He must miss his off-leash action, but he doesn't show it or complain, and I think he is quite content with what we are doing.

Home Exercises

At home we do exercises with Kenzo at least four times a day to strengthen his biceps and keep him flexible.

We let him stand with his front-legs on the couch, and move a treat up and down in front of him, and by following it he is working his biceps muscles, similar with push-ups.

The vet also provided us with a Fitpaws Balance Disk, which is also to strengthen his muscles. With his front paws placed on the disc we move a treat in a back and forth motion, or left to right, while he is balancing on the inflated disc.

You might wonder if getting your fingers nibbled upon by sharp front teeth for 5 minutes in a row is painful, yes, it is. No pain, no gain.

Next to the biceps excercises, we also do massages, and general stability excercises. Kenzo loves all the attention and we think we might continue with this also when he has healed completely. Who doesn't like a little bit of wellness and work-out.

Underwater Treadmill

Our biggest surprise. Kenzo hates the underwater treadmill. For a dog that loves everything that has something to do with water, this is clearly the exception. We hope it will get better by time, as the treadmill is such an important part of therapy.

Not only because it is great muscle training. Also because you can control the duration and difficulty-level, giving a great insight in how he is doing, and if he could be ready to be let off the leash on walks.

We use toys and treats to no avail, the treadmill remains a chore, and the only thing on his mind is how to get out of there.

Thankfully, Kenzo never lost a lot of muscle according to the vet, so it might not be necessary to do it more than 5, maybe 10 times. We'll see about that.

That's where we are now. 

If you have any suggestions for fun exercises we can do at home we would love to hear them. This will still take many months, before he is healed again, but we focus now on the first step, to go off leash.

His fur is coming back rather quickly, don't you think?

I hope the tendon heals just as fast.


Kenzo is the founding father of Kenzo the Hovawart blog. We got him as a puppy from a responsible breeder. Kenzo is an active dude and has participated in a lot of different dog training activities like obedience, "schutzhund", tracking and nosework. He even attended dog shows - alright, one - with good results.

Hovawart males tend to rival a lot with other male dogs, but Kenzo is one of the exceptions. He is just friendly by nature. A dog with a heart of gold.

Viva was adopted from the shelter when she was 5 years old, and we don't know a lot of her history. Viva came with a lot of health issues and fear of most other dogs, but is doing a lot better today. She is very persistent and has an iron will. When Viva wants something, she doesn't give up easily.

She loves to go for walks in large open spaces, where she can be sure there are no other dogs and she can investigate her surroundings undisturbed.

We are all living together in Copenhagen, Denmark.


  1. How about Laser Therapy?

    This would be a good addition to help with edema and help along healing.

    1. Thanks for the tip, Daniel. We are going to take that up.

  2. Poor guy! I hope you have pet insurance. My dog, Lilly, had a health scare a few months ago. It's definitely something worth looking into. http://www.thehowtodog.com/pet-health-insurance/